• Medicina clinica · Nov 2024

    Multicenter Study

    Digital devices for heart rhythm monitoring in atrial fibrillation patients scheduled for elective electrical cardioversion.

    • Juan Benezet-Mazuecos, Pau Alonso, José Miguel Lozano, Jefferson Salas, Oscar González Lorenzo, Moisés Rodríguez-Mañero, Irene Narváez, Álvaro Lozano, Ángel Miracle, Julián Crosa, and Isabel Barrio.
    • Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario La Luz, Madrid, España. Electronic address: jbenezet@quironsalud.es.
    • Med Clin (Barc). 2024 Nov 29; 163 (10): 496502496-502.

    Introduction And ObjectivesManagement in recent-onset atrial fibrillation (AF) is to achieve sinus rhythm (SR) by cardioversion (CV). However, frequently SR is spontaneously restored, making scheduled admission unnecessary and causing misutilization of healthcare resources. Emerging medical technology allows accurate heart rhythm monitoring. This study evaluated this technology in these patients, preventing unnecessary admission and providing an earlier management.MethodsA multicenter study was designed including patients with AF scheduled for elective electrical CV. Patients submitted ECG recordings to a central CoreLab daily, twice a day and whenever they present symptoms, until CV (spontaneous or scheduled) and a week afterwards. Whenever a spontaneous conversion to SR was detected, investigators were contacted to confirm SR and abort admission. Patients' satisfaction was evaluated using a test for perceived utility, convenience, and accessibility.Results74 patients were enrolled (age 62±10 years). Twenty-two patients (30%) showed spontaneous conversion to SR. A total of 22 admissions and 16 transesophageal echocardiograms were prevented. Among 52 patients admitted for CV, 45 (88%) were discharged in SR. During follow-up after conversion to SR (spontaneous or electrical), recurrences of AF occurred in 24 patients (34%). At the end of the follow-up 51 patients (69%) remained in SR. The CoreLab received 93% of the expected ECG transmissions. Patient's overall satisfaction score was 9.1 over 10.ConclusionDigital devices for heart rhythm monitoring can optimize the management of AF patients scheduled for elective CV, preventing unnecessary admissions and providing a more rational use of healthcare resources.Copyright © 2024 Elsevier España, S.L.U. All rights reserved.

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